Healthcare Provider Details

I. General information

NPI: 1003053083
Provider Name (Legal Business Name): RACHEL MARIE RANWEILER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2009
Last Update Date: 01/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13123 E 16TH AVE
AURORA CO
80045-7106
US

IV. Provider business mailing address

13123 E 16TH AVE
AURORA CO
80045-7106
US

V. Phone/Fax

Practice location:
  • Phone: 720-777-6857
  • Fax: 720-777-7207
Mailing address:
  • Phone: 720-777-6857
  • Fax: 720-777-7207

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License Number123919
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: